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Risk factors for developing pacing induced LV dysfunction: Experience from a tertiary center in the UK

Kanthasamy, Vijayabharathy; Papageorgiou, Nikolaos; Bajomo, Tomi; Monkhouse, Christopher; Creta, Antonio; Finlay, Malcolm; Lambiase, Pier D; ... Muthumala, Amal; + view all (2022) Risk factors for developing pacing induced LV dysfunction: Experience from a tertiary center in the UK. Pacing and Clinical Electrophysiology , 45 (3) pp. 365-373. 10.1111/pace.14442.

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Abstract

Background: The risk factors for developing pacing induced left ventricular dysfunction (LVD) in patients with high burden of right ventricular pacing (RVP) is poorly understood. Therefore, in the present study, we aimed to assess the determinants of pacing induced LVD. / Methods: Our data were retrospectively collected from 146 patients with RVP > 40% who underwent generator change (GC) or cardiac resynchronization therapy (CRT) upgrade between 2016 and 2019 who had left ventricular ejection fraction (EF) ≥50% at initial implant. / Results: A total of 75 patients had CRT upgrade due to pacing induced LVD (EF < 50%) and 71 patients with preserved LV function (EF ≥ 50%) had a GC. Primary indication for pacing in both groups was complete heart block. Male predominance (p =.008), prior myocardial infarction (MI) (p =.001), atrial fibrillation (AF) (p =.009), chronic kidney disease (CKD) (p =.005), and borderline low systolic function (BLSF) (EF 50%–55%) (p =.04) were more prevalent in the CRT upgrade group. Presence of AF (odds ratio [OR] = 3.05, 95% confidence interval [CI] 1.42–6.58; p =.004), BLSF (OR = 3.8, 95% CI 1.22–11.8; p =.02), and male gender (OR = 2.41, 95% CI 1.14–5.08; p =.02) were independent predictors for RVP induced LVD. Age (OR = 1.08, 95% CI 1.02–1.14; p =.005) and BLSF (OR = 5.33, 95% CI 1.26–22.5; p =.023) were independent predictors of earlier development of LVD after implant. / Conclusions: Our results suggested that AF, BLSF, and male gender are predictors for development of pacing induced LVD in patients with high RVP burden. LVD can occur at any time after pacemaker implant with BLSF and increasing age associated with earlier development of LVD.

Type: Article
Title: Risk factors for developing pacing induced LV dysfunction: Experience from a tertiary center in the UK
Location: United States
DOI: 10.1111/pace.14442
Publisher version: https://doi.org/10.1111/pace.14442
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: heart failure, left ventricular dysfunction, pacemaker, pacing induced left ventricular dysfunction, right ventricular pacing
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10160259
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